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Helping others is good, not least because of the happiness it brings to the giver. And it is hard not to admire Matt Wage, or Peter Singer. But why do the world’s poor have such a passive role in all of this happiness creation? Why are they not asked if they wish to participate, if they too feel the warm glow? Singer does nothing to persuade us that they have volunteered to be the objects of the “effective” altruism he endorses; indeed, Gallup and Afrobarometer polls show that Africans’ own priorities lie elsewhere. Instead, the evidence for effectiveness, on which the recipients might have their own views, is outsourced to technical outfits, such as GiveWell, that evaluate projects and organizations. GiveWell is Consumer Reports for altruists, listing value for money and establishing the minimum cost of saving a child’s life.
It is an illusion that lives can be bought like cars. For a start, the evidence is nearly always in dispute. The alleged effectiveness of the Deworm the World Initiative—which, at the time of this writing, ranked fourth in GiveWell’s list of top charities—runs contrary to the latest extensive review of the evidence by the Cochrane Collaboration, an organization that compiles medical research data. Maybe Cochrane is wrong, but it is more likely that the effectiveness of deworming varies from place to place depending, among many other things, on climate and on local arrangements for disposing of human waste.
Rwanda's president uses Singer's utilitarian calculus against his own people.
More broadly, the evidence for development effectiveness, for “what works,” mostly comes from the recent wave of randomized experiments, usually done by rich people from the rich world on poor people in the poor world, from which the price lists for children’s lives are constructed. How can those experiments be wrong? Because they consider only the immediate effects of the interventions, not the contexts in which they are set. Nor, most importantly, can they say anything about the wide-ranging unintended consequences.
However counterintuitive it may seem, children are not dying for the lack of a few thousand dollars to keep them alive. If it were so simple, the world would already be a much better place. Development is neither a financial nor a technical problem but a political problem, and the aid industry often makes the politics worse. The dedicated people who risked their lives to help in the recent Ebola epidemic discovered what had been long known: lack of money is not killing people. The true villains are the chronically disorganized and underfunded health care systems about which governments care little, along with well-founded distrust of those governments and foreigners, even when their advice is correct.
In today’s Rwanda, President Paul Kagame has discovered how to use Singer’s utilitarian calculus against his own people. By providing health care for Rwandan mothers and children, he has become one of the darlings of the industry and a favorite recipient of aid. Essentially, he is “farming” Rwandan children, allowing more of them to live in exchange for support for his undemocratic and oppressive rule. Large aid flows to Africa sometimes help the intended beneficiaries, but they also help create dictators and provide them with the means to insulate themselves from the needs and wishes of their people.
The industry does not ignore the evidence; indeed the World Bank, the U.S. Agency for International Development, and its European counterparts use the same evidence GiveWell does, and they help to create more. They are also infinitely better organized and funded than the NGOs, so if it were possible to use this sort of evidence to eliminate global poverty, they would be better placed to do so than a handful of wealthy individuals working through NGOs. Yet these official aid agencies cannot solve the political conundrum and must bear some of the burden of responsibility for the oppressive dictatorships that fester in Africa.
Like Singer, I am privileged to teach at Princeton. I too see students who want to relieve suffering in the world. Should they go to Dhaka or Dakar? Focus on bed nets or worms? I tell them to go to Washington or London and to work to stop the harm that rich countries do; to oppose the arms trade, the trade deals that benefit only the pharmaceutical companies, the protectionist tariffs that undermine the livelihoods of African farmers; and to support more funding to study tropical disease and health care. Or they could go to Africa, become citizens, and cast their lot with those they want to help. That is how they can save the lives of African kids.
Angus Deaton is the the Dwight D. Eisenhower Professor of Economics and International Affairs at Princeton University and author of The Great Escape: Health, Wealth, and the Origins of Inequality.
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